Lois Richardson has served as CHA’s legal resource for the past 24 years, primarily as legal counsel and most recently as vice president of legal publications and education. She is the author of numerous CHA publications, including the Consent Manual, California Hospital Compliance Manual, California Health Information Privacy Manual and California Hospital Survey Manual.

Lois has also served as the executive director for the California Society for Healthcare Attorneys since 2000, providing legal education and networking opportunities for California’s health care attorneys.

Lois has a bachelor’s degree in business administration finance from the University of California, Berkeley, and a juris doctor degree from the University of California, Hastings College of the Law.

Last week the California Court of Appeals ruled in Julian v. Mission Community Hospital, finding that California’s involuntary mental health evaluation and treatment laws do not confer a private cause of action. This means that a patient cannot sue a hospital or physician for involuntarily detaining, evaluating or treating him or her. The court held that only administrative agencies — such as the California Department of Public Health or the Medical Board of California — can enforce these laws against a hospital or physicians. The court also held that the hospital and physicians were not state actors under civil rights laws and, therefore, could not be liable for violating the plaintiff’s rights under the federal and California constitutions.

The case was certified for publication, which means that it may be cited as precedent in future lawsuits. It is unknown at this time whether the plaintiff will ask the California Supreme Court to review the case. The court’s decision is attached.

Effective Jan. 1, a hospital’s internal child abuse reporting policy may not direct employees to allow their supervisor to file or process a mandated report under any circumstances. The law was enacted because of concerns that supervisors at private foster family agencies had impeded social workers and teachers from making reports when they suspected child abuse.

The Cyber Health Working Group (CHWG) — a joint effort between InfraGard and the Federal Bureau of Investigation — invites health care information technology professionals to apply for membership in the group, which focuses on cybersecurity issues in the health care sector. CHWG members have access to a web-based platform that provides tools for its members to share cyber threat information and resources, as well as monthly webinars focused on a cyber threat or tool in the health sector. Members of the group include IT heads, chief information officers, network engineers and cybersecurity analysis; applicants must be a current InfraGard member or have an InfraGard application pending. More information is available in the attached flyer.

The federal Substance Abuse and Mental Health Services Administration (SAMHSA) has published in the Federal Register a final rule updating and clarifying the confidentiality of patient information regulations. SAMHSA intended the regulatory update to reflect changes in the health care delivery system since 1987, when the current regulations were issued — particularly electronic health information exchange and whole-person care. The final rule is effective Feb. 17.

The provisions of the rule apply to federally assisted substance use disorder programs. A general medical facility must comply with the rule only if it has an identified unit that holds itself out as providing substance use disorder diagnosis, treatment or referral for treatment, or has staff whose primary function is the provision of substance use disorder diagnosis, treatment or referral for treatment, and are identified as such.

The California Supreme Court ruled Tuesday that health plans like Anthem, Aetna, Cigna and Health Net may be responsible to noncontracting emergency services providers for unpaid bills when the plan knows or should have known that a delegated medical group was financially unsound.

In Centinela Freeman Emergency Medical Associates et al. v. Health Net, the defendant health plan delegated its emergency services financial responsibility to its contracting medical providers (also known as risk bearing organizations, or RBOs), three individual practice associations (IPAs). The IPAs failed to comply with multiple state financial solvency requirements beginning in 2007, and continuing through each quarter for the following four years, resulting in their failure to reimburse the plaintiff, noncontracting service providers, for emergency care they provided to plan enrollees. The IPAs eventually went out of business.

California hospitals are required to provide information about child car seat laws to the parents or other person to whom a child under the age of 8 is released. This requirement applies to all releases from the facility, not just from an emergency department or maternity ward.

Effective Jan. 1, 2017, children under 2 years of age must be secured in a federally-approved, rear-facing child passenger restraint system, unless the child weighs 40 or more pounds or is 40 or more inches tall. CHA Form 10-3, “Release of a Child Under 8 Years of Age,” has been revised to reflect the upcoming requirement. The form is available in English and Spanish at www.calhospital.org/forms-handouts for hospitals that wish to update their handouts now. CHA’s Consent Manual – A Reference for Consent and Related Health Care Law contains complete details about the handout requirement.

The U.S. Supreme Court has delayed the effective date of a Ninth Circuit Court of Appeals decision determining which faith-based organizations are exempt from complying with the federal Employee Retirement Income Security Act (ERISA). The delay (“stay”) will expire when the Supreme Court rules on the case or decides not to hear it.

ERISA is a complicated law meant to protect employees by requiring that pension plans be fully insured and funded so enough money is available to pay promised pensions when employees retire. The law exempts church pension plans. Many faith-based organizations have operated for years under the understanding that they qualified for this exemption. However, in Rollins v. Dignity Health, the Ninth Circuit Court of Appeals held that Dignity Health didn’t qualify for this exemption. To reach this conclusion, the court looked at how the plan was originally structured and how the structure changed over time. The Ninth Circuit determined that if a church itself established and maintained the plan, it is exempt from ERISA, even if it covered employees who work at church-affiliated schools and hospitals. But the Ninth Circuit concluded that if a church-affiliated school or hospital established and maintained the plan, it’s not exempt from ERISA.

Last week, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced that it has begun an initiative to more widely investigate breaches of protected health information (PHI) affecting fewer than 500 individuals. Previously, OCR had focused on larger breaches involving the PHI of 500 or more individuals.

OCR also announced that it will attempt to identify covered entities and business associates that appear to be underreporting breaches.

OCR regional offices retain discretion to prioritize which smaller breaches to investigate, but each office will increase its efforts to identify and obtain corrective action to address entity and systemic noncompliance related to these breaches.

Overview

Providing care to patients with mental health issues is complicated. It isn’t always easy to know what is “right” and what is “legal.”

The Mental Health Law Manual was written to help hospitals understand the laws governing mental health treatment as well as the rights of the patients they serve. The manual also details special protections for individuals who may be unable to make rational decisions regarding their care, specific requirements regarding the use and disclosure of health information and unique reporting requirements.

Overview

Who can legally give consent for treatment of a minor? Once a fairly simple question, the changing nature of families often complicates the answer. Providers must now frequently seek consent from separated or divorced parents, stepparents, foster parents, grandparents, guardians and other adults.

This guidebook guides you through the basic principles of patient consent for health care treatment. In clear, simple terms this publication explains why and when consent is necessary, who may give consent, how consent for minors is different, and procedures that require special consent. It also describes the hospital’s obligations when dealing with complicated issues such as advance health care directives, California’s POLST form, refusal of treatment, and end-of-life decisions, including California’s End of Life Option Act .

CHA’s Hospital Compliance Manual is the only publication written for hospital compliance officers that integrates California with federal law on high-risk compliance areas. Written by Hooper, Lundy & Bookman, PC, and CHA, the manual focuses on high-risk compliance issues and the key components of an effective compliance program.

From basic principles to specific procedures, the Consent Manual is your one-stop resource for all legal requirements related to patient consent for medical treatment, release of medical information, reporting requirements and more. Learn exactly what the law requires and what you need to do to comply.

Overview

Safe patient handling has been a focus of the health care community for nearly a decade. On June 19, 2014, the Cal/OSHA Standards Board adopted the much-anticipated Safe Patient Handling regulation. The regulation becomes effective on Oct. 1, 2014.

This guidebook explains the requirements of the Safe Patient Handling regulation, the elements of a back and musculoskeletal injury prevention plan, how to implement a plan in your facility, and what to expect regarding enforcement. The guidebook also provides resources helpful to compliance.

Overview

This comprehensive resource addresses all state and federal laws related to the privacy of health information, and provides guidance to help hospitals comply with increasingly complex regulations. Laws covered include:

Overview

The surveyors have arrived, unannounced, at your hospital. What do you do first? What will the surveyors do?

The California Hospital Survey Manual can help hospitals prepare for the survey process, and explains who the surveyors are and how they conduct their surveys. It covers the different types of surveys and possible outcomes, and:

Storing records needlessly is costly. Yet disposing of them prematurely raises legal concerns. This straightforward guidebook tells which records should be kept and for how long, and helps you establish an efficient records retention schedule. Included is an overview of legal and practical considerations in determining record retention policies.